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psnet.ahrq.gov/perspective/assessing-safety-electronic-health-records-what-have-we-learned
September 01, 2017 - of medication.( 28 )
Health IT is well-designed and working correctly, but was not configured, implemented … changed in an external system.( 14 )
Specific health IT safety features or functions were not implemented
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psnet.ahrq.gov/issue/promethazine-adverse-events-after-implementation-medication-shortage-interchange
October 26, 2010 - Study
Promethazine adverse events after implementation of a medication shortage interchange.
Citation Text:
Sheth HS, Verrico MM, Skledar S, et al. Promethazine adverse events after implementation of a medication shortage interchange. Ann Pharmacother. 2005;39(2):255-61.
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psnet.ahrq.gov/issue/rural-hospital-patient-safety-systems-implementation-two-states
February 03, 2011 - Study
Rural hospital patient safety systems implementation in two states.
Citation Text:
Longo DR, Hewett JE, Ge B, et al. Rural Hospital Patient Safety Systems Implementation in Two States. The Journal of Rural Health. 2007;23(3). doi:10.1111/j.1748-0361.2007.00090.x.
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psnet.ahrq.gov/issue/rapid-response-systems-should-we-still-question-their-implementation
January 06, 2017 - Commentary
Rapid response systems: should we still question their implementation?
Citation Text:
Winters BD, Pronovost P. Rapid response systems: should we still question their implementation? J Hosp Med. 2013;8(5):278-81. doi:10.1002/jhm.2050.
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DOI G…
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psnet.ahrq.gov/issue/implementing-optimal-team-based-care-reduce-clinician-burnout
January 16, 2019 - Book/Report
Emerging Classic
Implementing Optimal Team-Based Care to Reduce Clinician Burnout.
Citation Text:
Implementing Optimal Team-Based Care to Reduce Clinician Burnout. Smith CD, Corbridge S, Dopp AL, et al. NAM Perspectives. Washington DC: National Acade…
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psnet.ahrq.gov/issue/restorative-just-culture-exploration-enabling-conditions-successful-implementation
February 08, 2023 - Study
Restorative just culture: an exploration of the enabling conditions for successful implementation.
Citation Text:
Boskeljon-Horst L, Steinmetz V, Dekker SWA. Restorative just culture: an exploration of the enabling conditions for successful implementation. Healthcare (Basel). 2024;…
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psnet.ahrq.gov/issue/engineering-safety-practice-through-implementation-ehr-safer-guides
March 12, 2025 - Audiovisual
Engineering Safety into Practice through Implementation of the EHR SAFER Guides.
Citation Text:
National Action Alliance for Patient and Workforce Safety. Engineering Safety into Practice through Implementation of the EHR SAFER Guides. January 21, 2025, 12:00 - 1:00 PM (easte…
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psnet.ahrq.gov/issue/community-acquired-pneumonia-clinical-decision-support-implementation-toolkit
June 12, 2024 - Toolkit
Community-Acquired Pneumonia Clinical Decision Support Implementation Toolkit.
Citation Text:
Agency for Healthcare Research and Quality. Community-Acquired Pneumonia Clinical Decision Support Implementation Toolkit.
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Format:
Google Scholar BibTeX EndNo…
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psnet.ahrq.gov/issue/vhas-movement-change-implementing-high-reliability-principles-and-practices
August 21, 2024 - Commentary
VHA's movement for change: implementing high-reliability principles and practices.
Citation Text:
Cox GR, Starr LM. VHA's movement for change: implementing high-reliability principles and practices. J Healthc Manag. 2023;68(3):151-157. doi:10.1097/jhm-d-23-00056.
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psnet.ahrq.gov/issue/medication-safety-issue-brief-bar-code-implementation-strategies
June 17, 2014 - Fact Sheet/FAQs
Medication safety issue brief. Bar code implementation strategies.
Citation Text:
Association AH, Pharmacists AS of H-S, Networks H and H. Medication Safety Issue Brief. Bar Code implementation strategies. Hospitals & health networks. 2005;79(7):65-6.
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psnet.ahrq.gov/issue/field-guide-collaborative-care-implementing-future-health-care
March 09, 2018 - Book/Report
Field Guide to Collaborative Care: Implementing the Future of Health Care.
Citation Text:
Field Guide to Collaborative Care: Implementing the Future of Health Care. Uhlig P, Raboin WE. Overland Park, KS: Oak Prairie Health Press; 2015. ISBN: 9780991411290.
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…
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psnet.ahrq.gov/issue/reducing-surgical-errors-implementing-three-hinge-approach-success
December 08, 2021 - Commentary
Reducing surgical errors: implementing a three-hinge approach to success.
Citation Text:
Landers R. Reducing surgical errors: implementing a three-hinge approach to success. AORN J. 2015;101(6):657-65. doi:10.1016/j.aorn.2015.04.013.
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Format:
DOI Goo…
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psnet.ahrq.gov/issue/implementing-bedside-handoff-emergency-department-practice-improvement-project
November 14, 2018 - Commentary
Implementing bedside handoff in the emergency department: a practice improvement project.
Citation Text:
Campbell D, Dontje K. Implementing Bedside Handoff in the Emergency Department: A Practice Improvement Project. J Emerg Nurs. 2019;45(2):149-154. doi:10.1016/j.jen.2018.09.…
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psnet.ahrq.gov/issue/implementing-online-medication-reconciliation-large-academic-medical-center
January 23, 2019 - Commentary
Implementing online medication reconciliation at a large academic medical center.
Citation Text:
Bails D, Clayton K, Roy K, et al. Implementing online medication reconciliation at a large academic medical center. Jt Comm J Qual Patient Saf. 2008;34(9):499-508.
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psnet.ahrq.gov/issue/reducing-alarm-hazards-selection-and-implementation-alarm-notification-systems
June 27, 2018 - Newspaper/Magazine Article
Reducing alarm hazards: selection and implementation of alarm notification systems.
Citation Text:
Reducing alarm hazards: selection and implementation of alarm notification systems. Gee T, Moorman BA. Patient Saf Qual Healthc. March/April 2011;8:14-17.
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psnet.ahrq.gov/issue/implementation-structured-hospital-wide-morbidity-and-mortality-rounds-model
January 20, 2015 - Study
Implementation of a structured hospital-wide morbidity and mortality rounds model.
Citation Text:
Kwok ESH, Calder LA, Barlow-Krelina E, et al. Implementation of a structured hospital-wide morbidity and mortality rounds model. BMJ Qual Saf. 2017;26(6):439-448. doi:10.1136/bmjqs-201…
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psnet.ahrq.gov/node/46169/psn-pdf
June 07, 2017 - associations-between-hospital-characteristics-measure-reporting-and-centers-
medicare-medicaid
The Centers for Medicare and Medicaid Services (CMS) recently implemented
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psnet.ahrq.gov/node/37942/psn-pdf
May 04, 2014 - improving-handoff-communications-critical-care-utilizing-simulation-based-
training-toward
Simulation training is being widely implemented
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psnet.ahrq.gov/node/41437/psn-pdf
January 03, 2017 - This study implemented bedside
nursing handoffs at shift change as a patient-centered approach to reducing
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psnet.ahrq.gov/node/41116/psn-pdf
May 24, 2012 - The authors found that hospitals that had fully implemented the safe practices had a lower
incidence